Opioid treatment programs contracted by the Ventura County Behavioral Health Department for more than $5 million over seven months need far more county oversight and transparency, according to a new grand jury report.
The investigation focused on five opioid treatment clinics in the county run by Aegis Treatment Centers and Western Pacific Med Corp. Ventura County Behavioral Health contracts with the companies to provide opioid treatment involving medications like methadone and Suboxone, paying up to $4 million to Aegis from December through June and up to $1.17 million to Western Pacific. The money comes from federal and state funding.
On Tuesday, the Ventura County Board of Supervisors authorized renewing the contracts for another year. Aegis will be paid up to $6.9 million and Western Pacific up to $2 million over 12 months. Aegis runs clinics in Ventura, Oxnard, Santa Paula and Simi Valley. Western Pacific runs a clinic in Ventura.
The Ventura County Grand Jury report contends the behavioral health agency relies too heavily on state and government agencies for oversight, doing too little on its own. Investigators said the clinics are required to provide detailed reports of services and treatment outcomes to behavioral health but added the county agency shares none of that with the public.
"There's an awful lot of money being spent on the two providers," said Kay Diamond, foreperson of the 19-member grand jury that conducts civil investigations. "With that much money being spent, it's pretty important to keep an eye on the contractors. Are they performing to contract?"
Dr. Sevet Johnson, director of Ventura County Behavioral Health, said she couldn't comment on the report, noting she's required to limit reactions to the formal response that will be filed by Behavioral Health through the Board of Supervisors. Thaiphong Vo, a lawyer with Aegis Treatment Centers, also declined comment.
Mark Hickman, CEO of Western Pacific Medical Group, defended the county's level of oversight in the company's Ventura clinic and noted opioid treatment centers are also scrutinized by state and federal regulators.
"I believe there's a huge county presence. We've had a long working relationship," Hickman said, noting he had time for only a cursory read of the grand jury report. "Ventura County has really taken the lead in addressing the opioid epidemic."
That epidemic has scarred Ventura County. In 2018, opioids, including heroin and fentanyl, were involved in 96 of the 170 overdose deaths, according to the Ventura County Medical Examiner’s Office. Deaths rose from 92 in 2017 and 55 in 2016.
The grand jury said audits of the clinics performed by county behavioral health over five years showed problems with documentation. At one clinic, methadone dosage wasn't charted as required, investigators said.
Investigators said they also learned of issues including loitering, trespassing and drug sales in the immediate vicinity of the opioid clinics. They recommended ramping up security at the sites.
Hickman defended both the record-keeping and security at his site.
"I've never seen those problems at our facility," he said, noting a full-time security guard works at the Ventura clinic.
Mostly, grand jury investigators pushed for more monitoring and oversight, calling for more unannounced visits by Behavioral Health and more public data on treatment outcomes.
The grand jury also called for the Ventura County Auditor-Controller to conduct a performance and compliance review of Behavioral Health's contract with the opioid prevention providers.
The report is the second from the grand jury focusing on opioid addiction in 14 months. Last year, investigators called on Behavioral Health to consider spending more on prevention and less on treatment.
County leaders in a formal response rejected the recommendation, citing reasons including restrictions on funding through a government program called Drug Medi-Cal.
In the new report, the grand jury said addiction can result in a long continuing treatment regimen that involves medication used to fight the use of opioids. Grand jury members cited research that draws parallels between opioid use disorder and Type 2 diabetes.
They noted both issues involve lifelong management.
June 23, 2019
Ventura County Star
By Tom Kisken
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